Abstract
Objectives To highlight spinal dural arteriovenous fistula (dAVF) as a treatable cause of myelopathy
that is often misdiagnosed. Clinical progression, hallmark radiological findings,
and postoperative course of recovery are studied.
Patients and Methods Three patients with spinal dAVF were included in the study. Retrospective evaluation
of the progression of disease and treatment received was done. Two of them were managed
by surgical ligation of fistula, and the third patient was under observation because
of lack of localizing symptoms.
Results Two of the three patients had previously been diagnosed with multiple sclerosis,
and one of them had received steroids. The third case was easily diagnosed at an early
stage as the center had become adequately sensitized about the radiologic findings.
After surgical excision of the fistula, both operated cases recovered steadily but
significantly, regained significant neurologic functions despite being operated at
an advanced stage.
Conclusion Spinal dAVF is a rare entity. They have the potential to cause severe morbidity in
the form of myelopathic changes in the cord and paraparesis in advanced stages. They
can be misdiagnosed even after a magnetic resonance imaging evaluation as the appearance
of dilated perimedullary veins and cord changes are not easy to interpret and require
specific understanding of the radiologic changes that may occur. However, once diagnosis
has been established, an early interruption of the fistula leads to a good clinical
recovery.
Keywords
dural arteriovenous fistula - myelopathy - angiography - surgical excision of fistula
